EmailMe Form - Adoptable Application

APPLICANT INFORMATION

Name of the pet you wish to adopt: *

Your Name- First and Last *

Address *

City *

Zip Code *

Home Phone: (Home or Cell # required) *

Cell Phone: (Home or Cell # required) *

Email *

Your Age(you must be 21 or older to apply for a pet): *

Names and Ages of all others living in Household? *

How long at your current address *

Less than 6 months

A year or more

More than 5 years

10 years or more

If less than 3 years at current address, length of time at previous address:

Does your home owners insurance allow this breed? *

Yes

No

Are you currently renting? *

Yes

No

Landlord's full name and phone
required for verification to own pets. (Enter N/A if not renting) *

If you have your lease agreement showing you can have a pet, please upload here.

Hours worked each day:

Is someone home during the day? *

Yes

No

Who will be responsible for the animal’s care during the day?

Do you currently have a fenced in yard? *

Other:

Do you currently own any pets? *

Name, Age, Species and Breed of Current pets:

Under what circumstances would you not keep the pet? *

Have you done research on this breed and understand the responsibilities of ownership? *

Yes

No

Why do you want this particular animal? *

Other:

Have you adopted a pet from FAHS before? *

Yes

No

Who and when? What happened to this animal?

Have you ever adopted from another agency? *

Yes

No

Who and when? What happened to this animal?

Your current veterinarian? Your current pets must be up to date on vaccines for application approval.

Their phone number? *

Name of pets that have been seen by this veterinarian?

If you have vet records for your current pet(s) that will help us expedite your application, please upload here. If you need to send more attachments then we have space for please email them to info@fairhumane.org

If you have vet records for your current pet(s) that will help us expedite your application, please upload here.

Have you ever been convicted of a felony? *

Yes

No

Please Explain

We DO verify veterinarian records for current pets in your household. We DO require to speak with your Landlord if you are a renter. We DO require that you are at least 21 to adopt from us. We will NOT process your application if all of the required information for your situation is not provided. By submitting this application I certify the information provided on this application is true and accurate to the best of my knowledge. I also understand that falsified information or significant omissions will disqualify me from further consideration for adoption of a Fairfield Area Humane Society animal. You also agree to a home inspection at any time by our Humane Officer. THANK YOU for your interest in our animals! *

I certify